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Painless squeaking following cervical disc replacement: A case report

Athar Siddiqui, MBBS MRCS DBS McH Orth Ed.,1 Neil Wickham, MBBcH MRCS,2 Christopher Hulme, MBBS(Lond) FRCS(Eng) FRCS(Tr &Orth)1

1Department of Trauma and Orthopedics, Epsom and St. Helier University Hospitals NHS Trust, 2Department of Trauma and Orthopedics, St. Georges Healthcare NHS Trust

Abstract

Background

We present a case of painless squeaking following cervical disc replacement which to our knowledge has not previously been reported in the literature.

Methods

A 45 year old gentleman presented with severe right sided C6 radiculopathy. He complained of more than 6 weeks of severe dysaesthesia in the right arm with pain radiating into the hand, thumb, index, middle and ring fingers. MRI confirmed severe impingement of C6 and C7 nerve roots. After trying a period of conservative treatment he underwent anterior cervical decompression with total cervical disc replacement of C5-6 and C6-7.

Results

Being a keen athlete he started running at 6 months post operatively. At his 12 month outpatient he presented us with an audio file containing squeaking from his neck. This was recorded immediately following a 9.5 mile hard surface run. The squeak got progressively less in intensity over 12 hours and disappeared after 24 hours. All instances of squeaking occurred after exercise where impact (running) or vibration (cycling) took place. This was first noticed 6 months post operatively when he restarted exercising. All episodes were completely painless. At his 18 month outpatient review the squeaking had reduced in frequency and intensity. At his 24 month review it had abated completely.

Conclusion

The aetiology of this painless squeaking has been elusive and is likely to be multifactorial. However we hypothesise that the audible squeak associated with the prestige LP disc maybe related to specific design characteristics and needs further evaluation. 

keywords: 
Squeaking, Cervical, Total disc arthroplasty, prestige LP disc, case report
Volume 9 Article 44
doi: 
10.14444/2044